Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Patients Experiences => Topic started by: key on December 17, 2017, 09:36:12 PM
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Hello, brave LLers.
I'm not good at English, so I'm sorry if it is difficult for you to understand my English.
I underwent left tibia lengthening surgery yesterday in Japan.
This was the first PRECICE2 surgery in Japan !
I will lengthen the legs while working, so I underwent a surgery of only left tibia first.
After several months I will be operated on right side.
It is about 12 hours after surgery. It is AM 6 o'clock now in Japan time. Immediately after surgery, the pain was strong, but fentanyl patch was prescribed, now the pain is slight, about 2/10 on the Pain scale.
I have heard that lengthening wil start 1-2 weeks later.
There is little information about the precice nail in Japan, and I want to borrow your help if questions come up in the future. I will study English. Thank you.
age:over 30
original height: secret
goal:5〜6cm
clinic name: Shirayuri beauty clinic ( Shirayuri means White Lily)
surgeon: Dr Ito
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Did doc recommended precice for Internal tibial lengthening or was only your choice?
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How much will you have to pay for the whole surgery? Or yet what did they charge you for doing one leg at a time? I am just curious as I imagine Japan's living expenses are very high, for the majority, it is not cost effective nor wise to double the cost and time to heal. Also it is a very serious surgery, I don't know if you will be able to work as planned when you will be mentally and physically exhausted from the whole process and even during recovery. Then you will have to go back and do it all over again.
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Did doc recommended precice for Internal tibial lengthening or was only your choice?
PRECICE was my strong request.
In Japan, there was only ISKD as an internal-type in the past.
I worried about iskd's “run away nail” problem.
For this reason I requested the doctor to import the precise.
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How much will you have to pay for the whole surgery? Or yet what did they charge you for doing one leg at a time? I am just curious as I imagine Japan's living expenses are very high, for the majority, it is not cost effective nor wise to double the cost and time to heal. Also it is a very serious surgery, I don't know if you will be able to work as planned when you will be mentally and physically exhausted from the whole process and even during recovery. Then you will have to go back and do it all over again.
Since the price of both legs is over 100,000 dollars, I can not recommend it except for those who live in Japan.
I know the person who lengthened the leg while working in Japan. I think that it would be possible to do desk work.
I would like to progress this journey somehow.
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Thank you for sharing your experience here.
I wish you the best of luck with your lengthening. Very interesting to have someone from Japan and doing Precice.
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good
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I wish you well in your journey regardless. Thankyou for answering my questions.
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Thank you for sharing your experience here.
I wish you the best of luck with your lengthening. Very interesting to have someone from Japan and doing Precice.
Thank you for your encouragement!
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good
Thanks!
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I wish you well in your journey regardless. Thankyou for answering my questions.
You are welcome. Thank you!
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POD1 16:00
I have post-dural puncture headache from today’s afternoon.
I have a headache at sitting or standing, so I can not practice walking enough.
I took caffeine and acetaminophen. And I am resting now.
My left leg do not hurt so much at rest, but it hurts when moved.
I have appetite, no need for drip, but I am worried how long this headache will last.
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I had a humongous headache when getting up, it did not pass after 7-10 days so I had to transform blood from my hand to where the needle was. This happens to a lot of pregnant women supposedly, so ask about that procedure. It was some insane 10 minutes where i had to stand up on the bed with a huge headache meanwhile a big needle entered my back.
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hi, InferiorityComplex!
your treatment is called blood patch therapy.
It is most effective thearapy for post dural puncture headache.
Today POD 3 6:20, I received Brad Patch therapy. If this treatment is effective, I will be discharged from the hospital this evening.
The leg pain is 2/10(resting), 4/10(moving).
The painkiller is a fentanyl patch and Tramcet(Tramadol hydrochloride/Acetaminophen)4-6T/day.
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Not a lot of Japanese posters on here, glad that you're here on the forums and that you're doing well. Cosmetic surgery in general is still relatively taboo in Japan, and limb lengthening much more so, so it's very hard to find information about CLL.
I'm fluent in Japanese, so let me know if you ever need anything translated.
(Note to others, the below is pretty much the same thing as above.)
過去何名か日本人のメンバーが質問などをしていましたが、keyさんは当掲示板での初の日本人経験者なので、非常に貴重な日記になると思います。もし翻訳など必要があったら気軽に質問してください。
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I didn't know Shirayuri started to use PRECICE though I also live in Japan. It's really interesting to see your experiences, keep it up mate!
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Hello android！
I also write this diary as a part of English study,
If I'm in trouble with English I'd like to ask for your help.
I think the first Japanese who underwent LL surgery at this forum is ocy.
http://www.limblengtheningforum.com/index.php?topic=3734.msg56843#msg56843
ocy is great LL veteran and very kind guy.
Android, do you plan to undergo surgery in the United States?
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I didn't know Shirayuri started to use PRECICE though I also live in Japan. It's really interesting to see your experiences, keep it up mate!
Hello ketchum. unexpectedly here are many Japanese.
The precice nail is not listed in the clinic web at the present time. Probably if my progress goes well, it will also be listed in the treatment menu.
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Hello android！
I also write this diary as a part of English study,
If I'm in trouble with English I'd like to ask for your help.
I think the first Japanese who underwent LL surgery at this forum is ocy.
http://www.limblengtheningforum.com/index.php?topic=3734.msg56843#msg56843 (http://www.limblengtheningforum.com/index.php?topic=3734.msg56843#msg56843)
ocy is great LL veteran and very kind guy.
Android, do you plan to undergo surgery in the United States?
Great idea, you'll learn English in no time as long as you have a need for it. For me, I really wanted friends I could talk to, so it only took a couple years to become fluent in English. Granted that was over 20 years ago...
Wow, I had no idea he posted on here, I remember reading his blog (http://my-leg-lengthening.blogspot.com/) a while back! Interesting to know that he's a member here.
I'm still undecided on the doctor, but probably not in the US as it's quite expensive. I'm planning on taking a year off of work, so I don't need to be here either. Planning on surgery date around June/July 2018.
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Great idea, you'll learn English in no time as long as you have a need for it. For me, I really wanted friends I could talk to, so it only took a couple years to become fluent in English. Granted that was over 20 years ago...
Wow, I had no idea he posted on here, I remember reading his blog (http://my-leg-lengthening.blogspot.com/) a while back! Interesting to know that he's a member here.
I'm still undecided on the doctor, but probably not in the US as it's quite expensive. I'm planning on taking a year off of work, so I don't need to be here either. Planning on surgery date around June/July 2018.
I really think that I can not study English without a necessity. It is splendid that your English became fluent in several years.
It is a good idea to take a year off of work while the leg lengthening. I thought that I could do desk work, but now I feel a little regret.
POD3（yesterday)
Pain level
headacche: 5-6/10 → 1-2/10
left leg: 3/10、swelling++
Blood patch therapy worked very quickly for my headache yesterday, and on the same day I was discharged from the hospital!
But living with one foot alone is more difficult than I expected.
I am a bit tired today, I will post again later.
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POD 4
Pain level:3/10、swelling++
（headache has compleely gone.)
I took 6 tablets of Tramcet a day
The swelling of left leg improved a bit better than yesterday.
Side effects of painkillers tended to constipate me, but I defecated for the first time after surgery :)
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Glad to hear you're doing well key, good reminder about the constipation!
I hope that your pain and swelling will go down enough that you can concentrate on your work. It's going to be tough, but it'll be worth it.
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Hello Android!
I am encouraged by your comment.
POD5
pain level 4/10
swelling++,left calf circumference 37cm. right is only 33cm
I had some problems today.
When I received delivery, I was staggering and loading my left leg, so my pain worsened.
The load capacity of my device is about 22 kg.
The possibility that the Precice2 was broken by the load can not be said to be zero.
I would like to receive X-ray exams as soon as possible.
Today I took Tramcet 8T a day.
The fentanyl patch which had been sticked was lost by peeling off unnoticed.
In other words, my pain killer is now just only tramcet.
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Hello Key,
I'm a japanese woman living in tokyo.
I really appreciate your info on Precise2 in Japan!!
I have some questions, could you please answer them whenever you can.
1. Is Dr Ito still working with the doctor Tobita who was working at Nishi-shinnjyuku clinic?
2. Is Dr Ito the only choise at the shirayuri beauty clinic, or is it possible to choose of Dr Tobita, who is supposed to be more experienced in this operation?
3. In which hospital are you staying at? I remember a several years ago Dr Ito's clinic did not have a facility to hospitalize patients.
4. Is it true that after getting out the hospitalization, Dr Ito is only available very late at night since he so buzy with other facial cosmetic surgeries?
sorry asking so many, but I am too intimidated to ask this type of quiestion directly to Dr Ito...
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Hello Key,
I'm a japanese woman living in tokyo.
I really appreciate your info on Precise2 in Japan!!
I have some questions, could you please answer them whenever you can.
1. Is Dr Ito still working with the doctor Tobita who was working at Nishi-shinnjyuku clinic?
2. Is Dr Ito the only choise at the shirayuri beauty clinic, or is it possible to choose of Dr Tobita, who is supposed to be more experienced in this operation?
3. In which hospital are you staying at? I remember a several years ago Dr Ito's clinic did not have a facility to hospitalize patients.
4. Is it true that after getting out the hospitalization, Dr Ito is only available very late at night since he so buzy with other facial cosmetic surgeries?
sorry asking so many, but I am too intimidated to ask this type of quiestion directly to Dr Ito...
Hello, chibii!
I will answer your questions as far as I know.
1. Yes
2. I guess Dr Ito is only chief operator, Dr Tobita can operate you as assistant. But I do not know well about this, so please ask Dr Ito directly.
3. Shirayuri Beauty Clinic has hospitalization facilities in the same building.
4. I thought so, but I still do not know well because I only had one consultation after discharge from the hospital.
That time was not midnight.
If you pm to me, I may reply a little bit more in Japanese.
God bless
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Hello, chibii!
I will answer your questions as far as I know.
1. Yes
2. I guess Dr Ito is only chief operator, Dr Tobita can operate you as assistant. But I do not know well about this, so please ask Dr Ito directly.
3. Shirayuri Beauty Clinic has hospitalization facilities in the same building.
4. I thought so, but I still do not know well because I only had one consultation after discharge from the hospital.
That time was not midnight.
If you pm to me, I may reply a little bit more in Japanese.
God bless
Hi Key,
I've tried to reply to your PM a few times but somehow they dont show up...
Did you receive them?
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Hi Key,
I've tried to reply to your PM a few times but somehow they dont show up...
Did you receive them?
Yes, I received them.
I sent last PM to you at 03:11:54 PM. Please re-check.
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Dec 24
POD 7
Pain level 4/10
This day was the first consultation day after discharge.
I got X-ray examination, there was no problem with nail.
I have symptoms of pain and slight fever, but Doctor said that it is a general course range.
I was relieved.
I will consult the doctor again in a few days and lengthening will start.
I am a little anxious but I am looking forward to it.
God bless,
Key
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Dec 26
POD 9
I got the stitches in my leg removed.
Wound is small and clean, there are no signs of infection.
I had the first distraction session on that day!
ERC is heavy, I have a bit of pain from compression, but the lengthening itself does not hurt at all. Great!
I lengthened only 0.25mm.
After the next day I will lengthen the leg 0.25 mm 3 times a day (0.75mm/day).
I will report again after the next X-ray examination.
God bless,
Key
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Jan 7 , 2017
POD 21
It was a re-examination day yesterday.
I took a x-ray examination.
The doctor said that the left tibia was lengthened exactly and its bone formation was also satisfactory.
I will continue distraction of 0.75 mm per day as well as the former.
I attained 1 cm of leg lengthening today ! It's a little milestone.
Although it is now almost favorable progress, I have a pain in a knee and cannot fully extend a knee.
I was instructed to perform a stretch enough by the doctor.
There are still no signs of a ballerina foot.
Is there any person who uses a knee brace at the time of leg lengthening here?
http://surgicalsolutionspr.com/store/post-op-knee-bracing/tri-panel-knee-immobilizer-brace/
This is useful for prevention of knee Contracture?
God bless,
key
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Hello
Congratulations on reaching 1cm. I live in Japan too and would love to support you if I can. I completed LL many years ago successfully so it's great to see a Precise patient operated on in Japan.
A few questions that immediately come to mind.
1. Were you flexible before the operation? If not, devote your time to stretching your calf muscle regularly.
2. Did you doctor recommend the knee brace for the link you posted? I'd think it's best to focus on stretching than restricting range of motion but follow your doctors instryctions.
3. Are you mobile? Are you using crutches to get to work etc. To the combi etc
4. Are you free for a chat via skype or even a meet face to face?
Regards,
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Hello
Congratulations on reaching 1cm. I live in Japan too and would love to support you if I can. I completed LL many years ago successfully so it's great to see a Precise patient operated on in Japan.
A few questions that immediately come to mind.
1. Were you flexible before the operation? If not, devote your time to stretching your calf muscle regularly.
2. Did you doctor recommend the knee brace for the link you posted? I'd think it's best to focus on stretching than restricting range of motion but follow your doctors instryctions.
3. Are you mobile? Are you using crutches to get to work etc. To the combi etc
4. Are you free for a chat via skype or even a meet face to face?
Regards,
Hello, Tall Story!
Thanks for the reply.
1. I was not flexible before the operation. Now I have daily stretching exercises.
2. My doctor didn't propose using the knee brace. I read PDF(P408) below and had an interest in the knee brace.
https://www.hss.edu/files/LL-Motorized_Intramedullary_Nail_for_Management_of_Limb-length_Discrepancy_and_Deformity.pdf
quote of the page：
"Physiotherapy is instituted for tibial
lengthening, with a focus on ankle
dorsiflexion and knee extension.
The patient wears an ankle dorsiflexion
split during the day and
a knee extension brace at night."
3. I can go to the office using crutches now. It's possible to take a train, but I avoid a jam-packed train.
4. I'm sorry, I don't want to disclose my face and status now. Further, I can read English, but I am not good at listening.
If you have a personal question, please use PM.
God bless,
key
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Wow, taking the train! I imagine it's rough during rush hour. Not all stations have elevators either, but at least Japan has escalators, unlike cities like New York -- stairs only for most stations.
Glad you're doing well!
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Wow, taking the train! I imagine it's rough during rush hour. Not all stations have elevators either, but at least Japan has escalators, unlike cities like New York -- stairs only for most stations.
Glad you're doing well!
Hello Android,
I avoid the huge and crowded station like Shinjuku, but I take a train every week.
There are a lot of stairs in the subway, and it's hard, but I can climb stairs by crutches.
I will continue to make efforts.
God bless,
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Jan 19, 2018
POD 33
Soon my lengthened amount reaches 2 cm.
The lengthened amount by ERC and the length in the x-ray inspection were identical in a medical examination several days ago.
I take about 6T of Tramcet(painkiller) every day.
I sometimes feel the pain in the knee and an ankle, but it isn't terrible.
A ballerina foot isn't seen for the moment.
I am difficult to extend a left knee completely.
I got permission from doctor, began to wear a knee brace at night. http://a.co/5N8qa17
There is no serious trouble for the moment.
I'll apply myself to a stretch every day.
God bless,
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How's the LL going, key?
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Hello,long time no see.
My lengthened amount reached 3 cm.
However, there is bad news.
Since bone formation was bad, my lengthening rate was lowered to 0.25 mm/day.
Because I increased the quantity of work recently, I am busy.
I think that posting and PM reply will be delayed. I'm sorry.
God bless,
key
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私はYoutubeであなたの拡張されたビデオを見ました、私は確信していません、それは良いようです。
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Too bad about the drop in distraction rate, but it's good that you're halfway done lengthening. Good stuff!
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Key's been a bit absent, but his clinic updated their blog last month (https://shirabeau.exblog.jp/26484717/) with his progress pics. Allow me to translate.
Text basically compares ISKD and Precice, noting that the latter is better in every way -- like its reverse mechanism -- except for its higher cost. Turns out that Key was well-read and approached Dr. Ito if he could get Precice, even though the clinic didn't publicly offer it. Luckily the doctor was familiarized with Precice, as he had recently visited the US for additional training, and heard a lot of praise about the device.
As Key mentioned, NuVasive representatives told the doctor he was the first to perform limb lengthening with Precice in Japan. NuVasive reps were present for the procedure.
Photos are from seven weeks post-op, shows a 3 cm increase in femoral length of the left leg. His bow legs are improving as well. Doctor notes that Key is working while lengthening.
They're aiming for at least a 5 cm final distraction. The post ends with a box of snacks from Key to the staff as a token of appreciation (common gesture in Japan).
There is one more older post (https://shirabeau.exblog.jp/26287170/), lot of the same info about Precice, but there's a video of Key doing his lengthening with the external remote controller (ERC). He adds an interesting note, saying that he's utilizing the Baumann procedure (https://www.ncbi.nlm.nih.gov/pubmed/18021583) (Baumann is also cited in the official Precice ducumentation, page 8 (https://www.orthovative.com/images/produkte/deformitaeten/precice/16-NuVa-0766-PRECICE-Antegrade-Tibia-Operative-Technique-Guide.pdf)), and believes that lengthening to 8 cm is possible.
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it seems he's doing tibia
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it seems he's doing tibia
Haha, oops. You are correct, my mistake; please replace it in your head.
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POD 97
Hello, It's been a long time.
I reached 47mm lengthening yesterday.
Now I am lengthening left tibia 0.5 mm a day.
I was worried about how long I should lengthen, but I think that 6 cm is the goal.
Although there are no ballerina foot, I still can not fully extend my left knee.
I'm doing a stretch every day.
Regards,
key
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Hey, key, thanks for getting back to us with an update. It's much appreciated, seeing as it is not your native language.
All the best with the final stretch of your journey.
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POD 124
Hello.
My lengthened amount reached 6 cm 3 days ago.
The lengthening phase was very long, I got tired.
The lengthened amount by ERC and the length in the x-ray inspection were identical.
PRECICE is very precise.
Now I am in the consolidation phase.
My doctor said that the duration would be around six months.
Probably I'll undergo an operation of a right tibia in winter.
I'll report if there is any progress.
Regards,
key
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Congrats on finishing part one of lengthening!
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mistakenlly posted here, sorry
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I am from Canada, looking for anyone from any country to team up with me who also seaking to do the Leg lengthening surgery .
I have whatsaap or my email Van_779@hotmail.com
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So friend, how do you feel after 1year?
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Hi, Key. Are you still planning to undergo CLL in the other leg this winter?
Regards.
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https://shirabeau.exblog.jp/27225998/
Here is the clinic website in Japanese. In this article the doctor says his left knee doesn’t fully extend even after 11 months post surgery, which indicates procurvatum deformity. I really fell sorry for him but this is a lesson of how risky this surgery is even if you do it in a developed country like Japan.
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It could be corrected I believe..